2025-05-09T10:49:56-05:00 2024-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2023-07-01 391919806 COMMUNITY HEALTH SYSTEMS INC COMM 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 STEPHEN W SMITH CHIEF EXECUTIVE OFFICER 6083610311 2025-05-09 1 1 SOLOMON MARDAKHAEV P01806552 6105653930 2025-05-09 2023 2025-03-06 01:10:19Z STEPHEN W SMITH 74 ECLIPSE BOULEVARD BELOIT WI 535116214 9878816 0 X WWW.CHSOFWI.ORG X 1997 WI OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 10 10 144 13 0 0 4498647 3245943 7040577 6622846 49384 7277 1750 2750 11590358 9878816 0 0 0 0 7967960 7173707 0 0 0 4091987 4086367 12059947 11260074 -469589 -1381258 6394105 5764309 4048052 4799514 2346053 964795 X OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 1 0 6526841 0 6622846 COMMUNITY HEALTH SYSTEMS, INC. OPERATES TWO SITES AND VARIOUS OUTREACH SITES IN LOCAL SCHOOLS, OFFERING A COMPLIMENT OF MEDICAL, CHIROPRACTIC, DENTAL, BEHAVIORAL HEALTH, AND PSYCHIATRY SERVICES IN BELOIT AND DARLINGTON, WISCONSIN. DURING FISCAL YEAR 2024, THERE WERE 29,000 VISITS. 6526841 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 30 0 144 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X STEPHEN W SMITH 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 DR PRASHANTI PILLA CHIEF MEDICAL OFFICER 36.00 X 275000 0 2846 STEPHEN W SMITH CHIEF EXECUTIVE DIRECTOR 45.00 X 171134 0 21821 DR ANNE FRIDH CHIEF OPERATION OFFICER 45.00 X 131506 0 22778 MARY PINTARRO APNP NURSE PRACTIONER 32.00 X 140616 0 10097 DR LAURA ANDERSON NURSE PRACTITIONER 40.00 X 114912 0 14175 BROOKLYN TRUMPY DIRECTOR OF COMPLIANCE, QUALITY & RISK 45.00 X 110134 0 7627 CARYN DAVIS DIRECTOR OF FINANCE 45.00 X 85766 0 30728 DR JITESH PIMPALE DENTAL DIRECTOR 32.00 X 108093 0 5742 KRISTIN LOEHR CHAIR 0.50 X X 0 0 0 RUTH GRAY VICE CHAIR 0.50 X X 0 0 0 LARA HERMANN TREASURER 0.50 X X 0 0 0 DANIEL BAROLSKY SECRETARY 0.50 X X 0 0 0 YUSUF ADAMA DIRECTOR 0.50 X 0 0 0 JEREMY BROWN DIRECTOR (THRU MAR 2024) 0.50 X 0 0 0 LAUREN DAVIS DIRECTOR (FROM JUL 2023) 0.50 X 0 0 0 BRANDON GILES DIRECTOR (FROM MAY 2024) 0.50 X 0 0 0 CECILIA GILLHOUSE DIRECTOR (THRU NOV 2023) 0.50 X 0 0 0 JESSICA GONZALES DIRECTOR 0.50 X 0 0 0 BRETT GRANT DIRECTOR (THRU JUL 2023) 0.50 X 0 0 0 DORIS MULDER DIRECTOR 0.50 X 0 0 0 BRENDA PINSON DIRECTOR 0.50 X 0 0 0 1137161 0 115814 8 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 COMPUTER SOFTWARE SERVICE AND SUPPORT 252334 WIPFLI 10000 W INNOVATION DR SUITE 250 MILWAUKEE WI 53226 ACCOUNTING SERVICES 165681 TODD MARTIN DDS PC 613 SOUTHWIND DRIVE UNIT 102 LAKE GENEVA WI 53147 CONTRACTED DENTIST 124207 COMMUNITY LINK CONSULTING INC PO BOX 276 NEWMAN LAKE WA 99025 CONTRACTED CFO/ACCOUNTING SERVICES 106305 4 3105195 140748 3245943 PATIENT SERVICE REVENUE 621300 6547082 6547082 75764 75764 6622846 7277 7277 2750 0 2750 2750 2750 9878816 6622846 0 10027 X 583074 310233 272841 5365433 2999918 2365515 79307 26961 52346 686389 220831 465558 459504 258936 200568 19283 19283 56700 56700 1214235 591270 622965 86761 3191 83570 79857 3403 76454 401700 248459 153241 605832 482959 122873 23467 16560 6907 39920 20083 19837 60490 50450 10040 349714 321228 28486 MEDICAL & PHARMACY SUPP 908481 904487 3994 EQUIPMENT 121675 21457 100218 LICENSES & SUBSCRIPTION 51273 17232 34041 BAD DEBT EXPENSE 29166 29166 37813 17 37796 11260074 6526841 4733233 0 131175 70098 807417 333004 374297 199868 508429 550017 33045 33045 136917 53809 2915352 2183479 738073 731873 3664752 3792595 6394105 5764309 629678 814970 1260 26379 3417114 3958165 4048052 4799514 X 2346053 964795 2346053 964795 6394105 5764309 -1381258 0 X X 0 1 X 1 1 1 X 3116100 4427042 4813425 4498647 3245943 20101157 3116100 4427042 4813425 4498647 3245943 20101157 20101157 20715 1554 1528 51134 10027 84958 20186115 28148511 0.99580 0.99460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1055553 855542 200011 1859799 1327937 531862 731873 DUE FROM THIRD-PARTY REIMBURSEMENT 81035 RIGHT-OF-USE ASSETS - OPERATING 3045809 RIGHT-OF-USE ASSETS - FINANCE 665751 3792595 FINANCE LEASE LIABILITY 689631 OPERATING LEASE LIABILITY 3071121 LINE OF CREDIT 197413 3958165 9849650 0 9849650 29166 29166 9878816 11230908 0 11230908 29166 29166 11260074 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 29,166. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 29,166. X X 0 0 0 0 0 0 0 1 0 DR PRASHANTI PILLA CHIEF MEDICAL OFFICER 265000 0 10000 0 0 0 1631 0 1215 0 277846 0 0 0 STEPHEN W SMITH CHIEF EXECUTIVE DIRECTOR 153409 0 13825 0 3900 0 6319 0 15502 0 192955 0 0 0 DR ANNE FRIDH CHIEF OPERATION OFFICER 127306 0 0 0 4200 0 5452 0 17326 0 154284 0 0 0 MARY PINTARRO APNP NURSE PRACTIONER 140616 0 0 0 0 0 4907 0 5190 0 150713 0 0 0 PART I, LINE 7 SCHEDULE J, PART II, COLUMN (B)(II) REPORTS DISCRETIONARY INCENTIVE AMOUNTS THAT WERE APPROVED BY THE BOARD BASED UPON PERFORMANCE. FORM 990, PART III, LINE 2 IN APRIL OF 2024, CHS STARTED CHIROPRACTIC SERVICES IN THE BELOIT CLINIC, HIRING ONE FULL TIME CHIROPRACTOR. FORM 990, PART VI, SECTION A, LINE 8B THE CORPORATION'S GOVERNING BODY DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED AND APPROVED BY THE MEMBERS OF THE GOVERNING BODY AND MANAGEMENT BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST MAY INCLUDE, BUT ARE NOT LIMITED TO RELATIONSHIPS, ASSOCIATIONS, OR BUSINESS DEALINGS WITH VENDORS, SUPPLIERS, OTHER HEALTHCARE ORGANIZATIONS, OR INDIVIDUALS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMUNITY HEALTH SYSTEM, INC.'S (CHS) EXECUTIVE TEAM MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL DETERMINE WHETHER CHS CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT ISN'T REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN CHS' BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. IF THE GOVERNING BOARD OR CHS EXECUTIVE TEAM HAS REASONABLE CAUSE TO BELIEVE A MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE BOARD MEMBER/EMPLOYEE OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE BOARD MEMBER'S/EMPLOYEE'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM WILL DETERMINE IF THE BOARD MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AND SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE CORPORATION'S HUMAN RESOURCE MANAGER PROVIDES THE MEMBERS OF THE GOVERNING BODY WITH COMPENSATION DATA FOR COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) LATEST COMPENSATION SURVEYS. THE GOVERNING BODY ALSO PERFORMS AN ANNUAL PERFORMANCE REVIEW OF THE CORPORATION'S CHIEF EXECUTIVE OFFICER. THE MEMBERS OF THE GOVERNING BODY DETERMINE AND VOTE TO APPROVE THE COMPENSATION AMOUNTS FOR THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT PROVIDER EXPENSE: PROGRAM SERVICE EXPENSES 296,800. MANAGEMENT AND GENERAL EXPENSES 10,116. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 306,916. LAB SERVICES: PROGRAM SERVICE EXPENSES 125,385. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,385. 340B SERVICES: PROGRAM SERVICE EXPENSES 119,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 119,560. CONTRACED SERVICES: PROGRAM SERVICE EXPENSES 47,075. MANAGEMENT AND GENERAL EXPENSES 385,708. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 432,783. GENERAL SERVICES: PROGRAM SERVICE EXPENSES 1,540. MANAGEMENT AND GENERAL EXPENSES 12,263. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,803. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 910. MANAGEMENT AND GENERAL EXPENSES 193,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 194,138. INTERPRETING CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 21,650. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,650. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITEE AND THE FULL BOARD REVIEW AND APPROVE THE AUDIT.